Job Title: Remote Certified Pharmacy Technician

Job Description

We are seeking a dedicated Remote Pharmacy Technician to join our team working in the EST time zone. As a Pharmacy Technician, you will be responsible for reviewing Prior Authorizations for coverage determination for a Pharmacy Services department within a large healthcare insurance company. You will make initial approval or denial decisions before passing them to Pharmacists for final review. This role involves handling all health plans and medication types, with minimal phone work, mostly outbound calls if necessary.

Responsibilities

• Track coverage determination requests
• Obtain verbal authorizations
• Approve requests based on criteria
• Enter decisions into the PBM system
• Notify providers and members of decisions
• Respond to client inquiries
• Refer requests for specialty drugs
• Contact providers for additional information
• Notify stakeholders of decision outcomes
• Obtain detailed clinical information from prescribers
• Assist with inbound and/or outbound patient or physician calls if needed

Requirements

• High School diploma or GED
• State Registration AND National Certification
• Basic computer skills
• Experience with Prior Authorization processes
• Proficiency in Microsoft Office and Outlook
• Data entry skills

Work Environment

• This is a professional remote environment where you will work with multiple screens and systems.
• You must have a strong WiFi connection and a dedicated office space with a closed door.
• The shift is Monday to Friday, from 8 am to 8 pm (Open for 8-Hour Shifts) in your local time zone, with rotating weekends every 4-6 weeks and some holidays. Training is conducted from 10 am to 6:30 pm EST.
• The company provides equipment, including a computer, monitor, and headset.

Pay and Benefits

The pay range for this position is $18.00 - $20.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Apr 29, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.